While PD is common, it requires specialist management, so anyone who is thought to have the condition should be referred to a medical professional with the appropriate expertise and stay under their supervision – though a multidisciplinary team that includes the GP is highly likely to be more closely involved – for their care.

During the early stages of the disease, symptoms can be mild and so no treatment may be deemed necessary, but regular monitoring is important. As the disease progresses, various treatments can help relieve symptoms and maintain quality of life. Click on the treatment options below to find out more.

Supportive therapies

Supportive therapies can be very helpful. Examples include physiotherapy to ease muscle pain and stiffness, and improve walking, flexibility and general fitness; occupational therapy to identify areas of difficulty with everyday life and work out practical solutions; speech and language therapy to assist with swallowing and speech difficulties; and a dietitian to look at whether symptoms can be improved via dietary modifications, such as increasing fluid and fibre intake to ease constipation.

Medication

Medication is not curative – there is no such thing for PD – but can improve some symptoms, though none are free of side effects. Levodopa can help replenish dopamine levels in the brain and improve movement problems, but needs combining with either benserazide or carbidopa to stop the drug first being broken down in the bloodstream. The effects of levodopa tend to decrease as more neurons in the brain are lost, so the dose needs monitoring and increasing from time to time. It can also cause movement issues in itself, for example, uncontrolled jerkiness. Dopamine agonists (ropinirole, pramipexole) act as a substitute for dopamine in the brain so have a similar but milder effect compared to levodopa. However, they can cause sleepiness, confusion, hallucinations and compulsive behaviours such as gambling. Monoamine oxidase-B inhibitors (selegeline, rasagiline) and catechol-O-methyltransferase inhibitors (entacapone) stop dopamine being broken down, meaning there is more available for the body.

Surgery

Surgery is an option for some PD patients.

Managing symptoms

These management options are only for the PD itself and specific symptoms will also be treated as appropriate. For example, someone with urinary incontinence may see a physiotherapist for some exercises to strengthen the pelvic floor, may be provided with medication to try and improve matters, or may be listed for surgery if deemed suitable.

Whatever the chosen treatment, support is vital for someone with PD and those who look after them. Pharmacy staff have an important role in this, in tangible ways such as reminding someone about their eligibility for a seasonal flu jab and the one-off pneumococcal vaccination, as well as more general listening and signposting.